My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
COUNTRY CLUB
>
2808
>
2200 - Hazardous Waste Program
>
PR0538350
>
COMPLIANCE INFO_PRE 2019
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
8/18/2020 10:13:40 AM
Creation date
10/31/2018 12:52:41 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0538350
PE
2220
FACILITY_ID
FA0012734
FACILITY_NAME
SAFEWAY STORE 1769
STREET_NUMBER
2808
STREET_NAME
COUNTRY CLUB
STREET_TYPE
BLVD
City
STOCKTON
Zip
95204
CURRENT_STATUS
01
SITE_LOCATION
2808 COUNTRY CLUB BLVD
P_LOCATION
01
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\COUNTRY CLUB\2808\PR0538350\COMPLIANCE .PDF
QuestysFileName
COMPLIANCE
QuestysRecordDate
2/24/2016 5:47:02 PM
QuestysRecordID
3012298
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
4
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
Please pant a type . ( Form designed Far use on ago ( 12pgch ) typewriter. ) Form Appmved . OMB No . 2050i <br /> UNIFORM HAZARDOUS 1 . Genemmrlo Number 2 . Page t of SEylptiQ� ty Ba� peaSe Phone 4 , Manifest Tracking Number <br /> WASTE MANIFEST CAR 000 247 213 z 1L �I1IYY •• 'J6 --11{{ 3344tltl 018821370 JJ K <br /> 5 . Genem allow MailtigAddresstoligum T I1WGerenmfa Bbe (if dissonant mad amressl <br /> COLINTRY CLUB E Vr 2808 COUNTRY CLUB BLVD <br /> STOCKTON , CA 95204 <br /> Genenmfs PM1we : ) 4011 M <br /> B�TrannsporlerlCoompryNaame ' US . EPAIDNumber <br /> 11QpNer= ALSCCM <br /> WK 411MG42742 <br /> T. Transaction R CpWany Names US. EPAIDNwliber <br /> = RUM INC , WAIMM q MOD 095 03S 998 <br /> B . Desigramd Family Name and Site Address US VIDOL( MY I ®AFii33 INM U . S . EPA ID Numbs <br /> amL€9A" RWO V EVH Vb H IDD 073114554 <br /> '0I�{1t� V1 IB@ 4 <br /> Fauliya PM1we : 9 - <br /> 9e 9n . US . DOTOesaipem (mrludng Pmpa+ SipO Nene , HaraNdazs . lDIN r, 10 , 11 . T 11 . Taml 12unt 13 . WasNCodes <br /> HM era Fading Grwprit No . Type OuanSy W1Abt <br /> o X 1RQ , UNION , VdateAerill 2 . 1 ( DOTSP 11208) , ( RQ 002 DF 00015 P D001 D002 331 <br /> . . _ . 9 _ si , D002) , ERG #128 <br /> w X ' RQ , UN1791 , Waste Hypoddorite Solutions , S , PGII , 001 DF 00005 P D002 141 <br /> RQ ( D002) , ERG <br /> X ' RQ UN3175 , 111111351 SONS eoatauling Ilemmable liquid , 111 001 DF 00010 P D001 331 <br /> . : 419hler fluid Soaked dsarccal , Fire slarter logs ii <br /> 7eirclefunni 4 . 1 . PGII . RQ i ( DWIL FRG # 133 <br /> X " RO . UN 1851 , VWe Medicare , Liquid , Toxic, N .O .S ( STver, 000 DF 00115 P D007 D010 0011 <br /> Chramiuni 0 . 1 , PGlil , RQ ( D011 ) , ERG #151 331 <br /> 14 . Bpetlal HantllirglnsWNonsandPLtlitlonallnformanson <br /> 1 , ABEHV.01 / ASSAb9 / - AEROSOLS 1. A. 0SHWD51ABSHWJ5w SLEACH u. AESHWIS / ABSHWI5 - CHARCOALAND FIRE STARTER <br /> LOGS 4 . A8SHWI7 / ABSHW17 . OTC PHARMACEUTICALS IT: 14 . 14 . 81r59 . 1I <br /> 670303c <br /> 1S GENERATOR ' SIOFFEROR ' SCERS01 = 0N : IM1erebytletlara rattMmM of4esconinmenlamhOyaM aztvrz@ydeunLN ¢ baa byMepopaahippvgwne , aNantlasvfui . patlaged , <br /> movement mbeledlplacerdW , ¢ Mare Inagrewena inpacerceraimn WtomporlamNt 'mgmappfeimematioralandwtiorW 9avemmoutsell tims . Ilerpml shipmentantl Tamm Primmy <br /> IS di NaceienmelNiscensgnmentcenfwm tote terms Orme anached EPAA atedgmentof Can sent, <br /> loots Nat Nawasteminimiiation abatement damaged n4DCFi TA am alarge quare " onenmg cargo) ( 91 ama small quareygenenmr ) is We . <br /> Gei risOttemfs PrintadRypetl Bigni Monty Day Year <br /> wines sta � 09 17 18 <br /> r.Fempoloi ❑ EgoM1bom u . s . Ponolenbyreva <br /> � <br /> Trans stores cmremarewuyt : Dam lwdngu. s . : <br /> 1T. TranspomerPWiadetlarm of NeceiptofMamAala <br /> Transporter l Pimmayced Name Si Monty Day Year <br /> 1 Ic A 109 117 118 <br /> G S <br /> Irani TmmspMar Irmdfypetl Name grahae Mi Day Year <br /> � <br /> 1 1NDi w <br /> I 108 . Oiscrepanrylntllwfion5pace ❑ 0uantiy ❑ Type El is uo ❑ Partial Rejector ❑ Fufl been <br /> Maims ) Remmnm Number. <br /> 18b . Altions Fatlliry ( or GenentaN US . EPAIDNumber <br /> a Facon Wone : <br /> ou 10a . SgratunolNternete FaaliN (ar Generater) Monty Day Year <br /> sitQ <br /> U; % Hmea ws Wasm RepMMaragememM 0Cotles Qm , coansforhaaaNan was aboen4dwcesal , aM neyd gsyalemn) <br /> 0 1 . z a 4 . <br /> H141 H110 H141 H110 <br /> 30. D ' graletl Fatltiy Owneror Openmr Cvtifi ' nof NIN ousmamrlalswveetl b) Nemanifea( e � p rgetl In lmm 183 <br /> 11 <br /> ( m Name SgnaN Mg O Day Y <br /> EPA 8 6 ( Rev. 3 ) Previous edit aoomsedete . DESIGNATED FACILITY TO DESTINATIO TATE ( IF R OUIRED) <br />
The URL can be used to link to this page
Your browser does not support the video tag.